Skip to main content
Log in

Nocturnal oxygen saturation and sleep quality in patients with advanced chronic obstructive pulmonary disease during treatment with moderate dose CR-theophylline

  • Originals
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Summary

The effect of a 24-h controlled-release (CR) preparation of theophylline (Th) on nocturnal arterial oxygen saturation (SaO2) and sleep quality has been evaluated in 7 patients with advanced chronic obstructive pulmonary disease (COPD) in a double-blind cross-over experiment; median values: age 61 y; PaO2 8.0 kPa; PaCO2 5.8 kPa.

During treatment with 450–900 mg Th in the evening, morning plasma drug levels ranged from 5.2–12.9 µg·ml−1. During Th and placebo treatment, the median evening FEV1 was 0.45 l and 0.46 l, respectively, and the morning FEV1 was 0.53 l and 0.41 l.

Sleep was monitored by whole-night polysomnographic recording of oximetric SaO2, airflow, respiratory and body movements (static charge sensitive bed), eye movements and submental electromyogram.

There was no significant difference between Th and placebo in sleep quality. Th treatment was associated with a marginal improvement in nocturnal oxygenation in most of the patients; the average nocturnal SaO2 ranged from 84.4%–92.8% during Th and from 82.2–90.5% during placebo treatment, respectively.

Only in the morning, during the last 2 h in bed, was the slight difference in SaO2 statistically significant in favour of Th.

It is concluded that a moderate dose of CR-theophylline did not alter the sleep quality or substantially improve nocturnal oxygenation in patients with advanced COPD and mild to moderate day-time hypoxaemia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Douglas NJ, Calverley PMA, Legget RJE, Brash HM, Flenley DC, Brezinova V (1979) Transient hypoxemia during sleep in chronic bronchitis and emphysema. Lancet 1: 1–4

    PubMed  Google Scholar 

  2. Wynne JW, Block AJ, Hemenway J, Hunt LA, Flick MR (1979) Disordered breathing and oxygen desaturation during sleep in patients with chronic obstructive lung disease (COLD). Am J Med 66: 573–579

    PubMed  Google Scholar 

  3. Catterall JR, Calverley PMA, MacNee W (1985) Mechanisms of transiet nocturnal hypoxemia in hypoxic chronic bronchitis and emphysema. J Appl Physiol 59: 1698–1703

    PubMed  Google Scholar 

  4. Douglas NJ, Flenley DC (1990) Breathing during sleep in patients with chronic obstructive pulmonary disease. State of the art. Am Rev Respir Dis 141: 1055–1070

    PubMed  Google Scholar 

  5. Fletcher EC, Luckett RA, Miller T, Costarangos C, Kutka N, Fletcher JG (1989) Pulmonary vascular hemodynamics in chronic lung disease patients with and without oxyhemoglobin desaturation during sleep. Chest 95: 757–764

    PubMed  Google Scholar 

  6. Dull WL, Alexander MR (1984) Theophylline in stable chronic airflow obstruction. Arch Intern Med 144: 2399–2401

    PubMed  Google Scholar 

  7. Hill NS (1988) The use of theophylline in “irreversible” chronic obstructive pulmonary disease — an update. Arch Intern Med 148: 2579–2584

    PubMed  Google Scholar 

  8. Rhind GB, Connaughton JJ, McFie J, Douglas NJ, Flenley DC (1985) Sustained release choline theophyllinate in nocturnal asthma. BMJ 291: 1605–1607

    PubMed  Google Scholar 

  9. Viljanen A (1982) Reference values for spirometric, pulmonary diffusing capacity and body plethysmographic studies. Scand J Clin Invest 42 [Suppl 159]: 1–50

    PubMed  Google Scholar 

  10. Brander PE, Sovijärvi ARA, Salmi T, Hakulinen A, Poppius H (1990) Nocturnal oxygen saturation and body movements in asthmatics treated with controlled-release preparations of theophylline or terbutaline. Eur J Clin Pharmacol 39: 117–121

    PubMed  Google Scholar 

  11. Salmi T, Brander PE (1989) Computerized polysomnographic recording and analysis in patients with COPD. Eur Respir J 2 [Suppl 8]: 796s

  12. Salmi T, Telakivi T, Partinen M (1989) Evaluation of automatic analysis of SCSB, airflow and oxygen saturation signals in patients with sleep related apneas. Chest 96: 255–261

    PubMed  Google Scholar 

  13. Svanborg E, Larsson H, Carlsson-Nordlander B, Pirskanen R (1990) A limited diagnostic investigation for obstructive sleep apnea syndrome. Oximetry and static charge sensitive bed. Chest 98: 1341–1345

    PubMed  Google Scholar 

  14. Mordelet-Dambrine M, Baglin J-Y, Roux A, Dusser D, Flouvat B, Huchon G (1986) Comparison between theophylline analysis by nephelometric inhibition immunoassay and high performance liquid chromatography. Ther Drug Mon 8: 106–110

    Google Scholar 

  15. Lam A, Newhouse MT (1990) Management of asthma and chronic airflow limitation. Are methylxanthines obsolete? Chest 98: 44–52

    PubMed  Google Scholar 

  16. DalNegro R, Turco R, Pomari C, Cordaro CI (1987) Clinical use of controlled-release theophylline in chronic airways obstruction. J Int Med Res 15: 391–396

    PubMed  Google Scholar 

  17. Chrystyn H, Mulley BA, Peake MD (1988) Dose response relation to oral theophylline in severe chronic obstructive airways disease. BMJ 297: 1506–1510

    PubMed  Google Scholar 

  18. Rogers RM, Owens GR, Pennock BE (1985) The pendulum swings again. Toward a rational use of theophylline. Chest 87: 280–282

    PubMed  Google Scholar 

  19. Karttunen P, Tukiainen H, Nykänen S, Saano V (1985) Nighttime pharmacokinetics of once a day theophylline: a steady state comparison of three preparations. Int J Clin Pharmacol Ther Toxicol 23: 161–165

    PubMed  Google Scholar 

  20. Ebden P, Vathenen AS (1987) Does aminophylline improve nocturnal hypoxia in patients with chronic airflow obstruction? Eur J Respir Dis 71: 384–387

    PubMed  Google Scholar 

  21. Berry RB, Desa MM, Branum JP, Light RW (1991) Effect of theophylline on sleep and sleep-disordered breathing in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 143: 245–250

    PubMed  Google Scholar 

  22. Brezinova V, Catterall JR, Douglas NJ, Calverley PMA, Flenley DC (1982) Night sleep of patients with chronic ventilatory failure and age matched controls: number and duration of the EEG episodes of intervening wakefulness and drowsiness. Sleep 5: 123–130

    PubMed  Google Scholar 

  23. Fleetham J, West P, Mezon B, Conway W, Roth T, Kryger M (1982) Sleep, arousals, and oxygen desaturation in chronic obstructive pulmonary disease. The effect of oxygen therapy. Am Rev Resp Dis 125: 429–433

    Google Scholar 

  24. Martin RJ, Cicutto LC, Ballard RD, Goldenheim PD, Cherniak RM (1989) Circadian variations in theophylline concentrations and the treatment of nocturnal asthma. Am Rev Respir Dis 139: 475–478

    PubMed  Google Scholar 

  25. Zwillich CW, Neagley SR, Cicutto L, White DP, Martin RJ (1989) Nocturnal asthma therapy. Inhaled biltorterol versus sustained-release theophylline. Am Rev Respir Dis 139: 470–474

    PubMed  Google Scholar 

  26. Alihanka J (1982) Sleep movements and associated autonomic nervous activities in young male adults. Acta Physiol Scand Suppl 511: 1–85

    PubMed  Google Scholar 

  27. Salmi T, Leinonen L (1986) Automatic analysis of sleep records with static charge sensitive bed. EEG Clin Neurophysiol 64: 84–87

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brander, P.E., Salmi, T. Nocturnal oxygen saturation and sleep quality in patients with advanced chronic obstructive pulmonary disease during treatment with moderate dose CR-theophylline. Eur J Clin Pharmacol 43, 125–129 (1992). https://doi.org/10.1007/BF01740657

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01740657

Key words

Navigation